What Is Sociopathic Personality Disorder (SPD)?

Medically reviewed by Melissa Guarnaccia, LCSW
Updated November 7, 2023by BetterHelp Editorial Team

Sometimes referred to as antisocial personality disorder, sociopathic personality disorder (SPD) is a mental illness that’s categorized as a cluster B disorder. These are characterized by “difficulties controlling emotions and behavior” as well as behaviors that others may consider to be “dramatic, emotional, or erratic”. SPD symptoms exist on a spectrum and can vary from individual to individual. However, they often manifest as actions that reflect little to no regard or consideration for social norms, including manipulating other people, displaying aggression, or breaking rules and laws. Read on for more information about this disorder.

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Understanding SPD Is The First Step To Coping With It

Recognizing Sociopathic Personality Disorder

Only a qualified mental health professional can make an accurate diagnosis of serious mental health conditions like this. That said, there are certain early warning signs and symptoms that may indicate a person is experiencing SPD. If you suspect that you or a loved one may have any other mental health conditions, it’s typically wise to consult with a licensed professional. Signs and symptoms of SPD may include:

  • Manipulating or exploiting others
  • Exhibiting antisocial behavior or a disregard for social norms
  • An inability to control anger
  • Engaging in criminal behavior
  • Struggling to meet work or financial responsibilities
  • A lack of guilt, remorse, or the ability to learn from mistakes
  • Difficulty sustaining healthy, long-term relationships

What Causes Sociopathic Personality Disorder?

While the specific cause of sociopathic personality disorder remains unknown, many experts believe it develops during childhood and can be traced back to a combination of internal and external factors.

For instance, studies suggest that genetic factors and individual physiology may play a role in the development of sociopathic tendencies. Another study found that a family history of antisocial behavior, specifically in a parent, was a strong predictor for conduct issues to persist from childhood into adolescence. Some experts believe that factors like inherited genes aren’t sure predictors of SPD or related disorders. Instead, they can most likely be thought of as potential contributors. They can also change over time with the child’s physical growth, environmental conditions, and other external factors, which means that some or all sociopathic tendencies that may be present in a person in childhood can either increase, decrease, or cease completely depending on how their environment and circumstances may change as time goes on.

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How SPD Is Diagnosed

SPD can only be diagnosed in people aged 18 years and older (after they have displayed a history of behavior that meets the DSM-5 criteria.) Before the age of 18, a child displaying these signs may be diagnosed with a conduct disorder. Those who present with a childhood conduct disorder will often show similar signs to adults experiencing SPD, including threatening behavior, physical aggression, lying, and a disregard for rules or laws. Causes for conduct disorders can vary, but one common cause is child abuse. One study found that children who experience abuse have a 50% chance of displaying conduct problems. In addition, another study found that up to 50% of children who have been diagnosed with a conduct disorder end up developing antisocial personality disorder later in life. 

As with many types of personality disorders, SPD can be difficult to diagnose—in part because an individual who has it is likely to deny it and resist evaluation or treatment. They may believe their antisocial personality or behavior is a reaction to the perceived negative qualities of others rather than an indication of a mental health issue. For example, someone with sociopathic personality disorder may show a repetitive pattern of violence or aggressive behavior, such as consistently engaging in physical altercations with others without cause. The person may then blame others for this violent behavior, citing a non-existent threat or insult as the inciting incident. Another example of this denial could relate to manipulation. A person with SPD may threaten self-harm or claim they plan on attempting suicide in order to manipulate someone or get their attention. When caught in a lie, they may blame the person for not paying attention to their needs. 

Even in cases where someone may not be telling the truth, suicide should be taken seriously. If you or someone you love is experiencing suicidal thoughts or talking about suicide, it's important to reach out immediately. Dial 988 to reach the 988 Suicide and Crisis Lifeline, which is available 24/7.

People with antisocial personality disorder who do seek treatment often do so because of another issue, such as substance use problems, depression, or relationship conflict. Or, the individual may be mandated to undergo evaluation and treatment by court order as part of sentencing for a crime. It’s under these circumstances that a psychologist may observe the signs of SPD and investigate further in order to come to a diagnosis.

The process of evaluating someone for a disorder like SPD must be done by a qualified mental health professional. It will typically include a physical examination, cognitive testing, interviews with family or loved ones, and/or a review of the patient’s medical and personal history. The psychologist will also compare the individual’s symptoms with the criteria for an SPD diagnosis in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). To be diagnosed with sociopathic personality disorder according to the DSM-5, the patient must meet the following criteria:

  • A pattern of disregarding the rights of others since age 15, which can take the form of impulsive behavior, violations of the law, repeated deceit—including for pleasure or profit, aggressiveness and a tendency to engage in physical fights, irresponsibility, and a lack of remorse
  • A history of behavioral issues before age 15 as well
  • Being at least 18 years of age
  • Confirmation that the above behaviors cannot be attributed to schizophrenia or bipolar disorder

Once their assessments are complete, the provider may determine a diagnosis and will then suggest an appropriate treatment plan.

How SPD Is Treated

Although SPD isn’t curable, a combination of psychotherapy and medication may help an individual manage their symptoms, enabling them to function more effectively within society and personal relationships. Medications such as antidepressants, antipsychotics, or mood stabilizers may be suggested, potentially in addition to some form of psychotherapeutic treatment. 

Little evidence exists to show that traditional cognitive behavioral therapy (CBT) methods are effective in treating SPD, although studies do suggest that it can be effective for treating other personality disorders. However, an individual may still benefit from getting therapeutic treatment for their symptoms, such as anger or addiction issues. 

Finally, it’s important to note that childhood intervention for those displaying signs of antisocial personality disorder may help in certain cases, according to research. Unlike some other mental health disorders, the intensity of symptoms from a personality disorder like SPD often decreases as the individual ages. In some cases, an individual who displayed troubling behavior in their youth—like harming animals or breaking the law for personal gain, for instance—may outgrow these tendencies on their own because of physiological changes, the realization of consequences, and social stigma for their behavior, or a combination of both.

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Understanding SPD Is The First Step To Coping With It

The Role Of Online Therapy

An individual who has a suspected personality disorder like SPD should typically be evaluated in person by a qualified clinician. If that provider recommends therapy to help the person manage symptoms of diagnosed SPD, such as anger issues or substance use problems, they may choose to pursue it in person or online depending on their unique situation. Research suggests that in-person and virtual therapy can offer similar benefits in many cases; a licensed provider can impart whether they believe a particular individual may benefit from one format over the other. That said, the availability of online therapy can be useful for those who may have difficulty traveling to and from appointments. 

Finally, in-person or online therapy may also be helpful for family or friends of a person who has a disorder like SPD since coping with their often difficult personality traits and behaviors can be challenging. A therapist can provide support in cases like these. If you’re interested in pursuing online therapy, a platform like BetterHelp is one option. You can fill out a brief questionnaire and get matched with a licensed therapist whom you can speak to via phone, video call, and/or online chat to address the challenges you may be facing.

Takeaway

Sociopathic personality disorder is a serious mental health condition. While it can’t typically be cured, professional treatment may help an individual manage their symptoms in order to improve daily functioning and to defend their well-being and the well-being of those around them.

Work through personality disorder symptoms

The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
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